Karen McCurdy

The links between types of maltreatment and demographic characteristics of children

This paper examines the relative impact of demographic characteristics of the child, family structure, and economic variables on types of child abuse and neglect. The current analysis is based on data from the second National Incidence Study of Child Abuse and Neglect (NIS-2), which collected information from both CPS and non-CPS agencies (e.g., schools, hospitals) in a national sample of 29 counties (Westat, 1988). The NIS-2 offers a unique opportunity to examine abuse and neglect issues with a large, national data set. This paper looks at a series of exploratory logistic regression models to distinguish between four different types of maltreatment: (a) physical abuse, (b) sexual abuse, (c) emotional maltreatment, and (d) physical neglect. Our findings show that physical neglect, in comparison with the other types of abuse, is the most predictable and distinguishable. It is most clearly related to economic factors such as low income and Aid to Families with Dependent Children (AFDC) status, regardless of race. Additionally, both sexual abuse and physical neglect occur at younger ages than previously shown. The policy implications for these findings are discussed.

Can Home Visitation Enhance Maternal Social Support

This study investigates the impacts of Healthy Start, a statewide, home visitation program, on the social support systems of 212 disadvantaged mothers in Oahu, Hawaii. Maternal support was assessed at the time these mothers gave birth and 12 months later with the Maternal Social Support Index. Comparisons of mothers randomly assigned to visited (n = 108) or nonvisited (n = 104) conditions uncover few differences on structural or affiliational aspects of support after 12 months. Visited mothers, however, are significantly less likely to report a decline in satisfaction with a close adult than nonvisited mothers do. The discussion examines the challenges of fostering social support and the ability of home visitation efforts to achieve this outcome.

Interventions to Prevent Child Maltreatment

The term child maltreatment has been used by advocates and policy makers to describe a set of individual behaviors toward children as well as a set of social conditions (Daro, 1989; Helfer, Kempe, & Krugman, 1997). Parental behaviors considered as abusive or neglectful include, among others, the willful or intentional physical beating of a child; the failure to provide for a child’s basic emotional and physical needs; overt emotional abuse of a child through continuous belittling, inappropriate control, or extreme inconsistency; and the sexual mistreatment of a child or use of a child for sexual pleasure. Social norms and public policies that condone and, sometimes, promote corporal punishment or high levels of violence and sexually explicit language in the media as well as child poverty, inadequate housing, failing educational systems, and limited access to preventive health care also represent, in the eyes of some, society’s collective maltreatment of its children (Garbarino, 1997; Straus, 1994). Given this diversity in perspectives, it is understandable that the fi eld has struggled with defi ning the problem’s scope, consequences, and appropriate interventions. Setting aside the issue of social conditions and inadequate welfare and support systems, the number of children directly abused or neglected is substantial. One of the earliest and most rigorous studies on the annual incidence of maltreatment estimated that in 1968 between 2 and 4 million families either failed to act or used physical force with the intent of hurting, injuring, or killing their children (Gil, 1970). Since that time, repeated household surveys and national incidence studies consistently document a problem of substantial proportion and one that affects children of all ages and socioeconomic groups (Finkelhor, Ormrod, Turner, & Hamby, 2005; Gelles & Straus, 1988; Sedlak & Broadhurst, 1996). Indeed, state and local child protective services (CPS) agencies investigated or assessed an estimated 1,800,000 referrals alleging child abuse or neglect in 2002. These referrals included more than 3 million children and, of those, approximately 869,000 (12.3 per 1,000)

Associations between family food behaviors, maternal depression, and child weight among low-income children☆

Although low-income children are at greater risk for overweight and obesity than their higher income counterparts, the majority of poor children are not overweight. The current study examined why such variation exists among diverse young children in poor families. Cross-sectional data were collected on 164 low-income, preschool aged children and their mothers living in two Rhode Island cities. Over half of the sample was Hispanic (55%). Mothers completed measures of family food behaviors and depression while trained assistants collected anthropometric data from children at seven day care centers and a Supplemental Nutrition Assistance Program outreach project. Multivariate analysis of covariance revealed that higher maternal depression scores were associated with lower scores on maternal presence when child eats (P < .05), maternal control of childs eating routines (P < .03), and food resource management skills (P < .01), and with higher scores on child control of snacking (P < .03) and negative mealtime practices (P < .05). Multiple regression results revealed that greater maternal presence whenever the child ate was significantly associated with lower child BMI z scores (β = .166, P < .05). Logistic regression analyses indicated that higher scores on food resource management skills reduced the odds of child overweight (odds ratios = .72-.95, P < .01). Maternal depression did not modify the relationship between family food behaviors and child weight. Overall, caregiver presence whenever a child eats, not just at meals, and better parental food resource management skills may promote healthier weights in low-income preschoolers. Further research is needed to identify the mechanisms that connect caregiver presence and food resource management skills to healthier weights for this age group.

Measuring family food environments in diverse families with young children

This study reports the development and validation of the 20 item Family Food Behavior Survey, a measure designed to assess broad components of the family food environment that may contribute to child overweight. In a diverse sample of 38 parents, factor analyses verified 4 domains: (1) maternal control of child eating behavior; (2) maternal presence during eating; (3) child choice, and (4) organization of eating environment. All domains achieved acceptable internal reliability (alphas= .73, -.83), and test-retest reliability. Mothers of overweight children scored significantly lower on maternal presence and somewhat higher on maternal control than mothers of normal weight children.

The Role of Community in Facilitating Service Utilization

SUMMARY Guided by an integrated theory of parent participation, this study examines the role community characteristics play in influencing a parents decision to use voluntary child abuse prevention programs. Multiple regression techniques were used to determine if different community characteristics, such as neighborhood distress and the communitys ratio of caregivers to those in need of care, predict service utilization levels in a widely available home visiting program. Our findings suggest that certain community characteristics are significant predictors of the extent to which families utilize voluntary family supports over and above the proportion of variance explained by personal characteristics and program experiences. Contrary to our initial assumptions, however, new parents living in the most disorganized communities received more home visits than program participants living in more organized communities. The article concludes with recommendations on how community capacity building might be used to improve participant retention.

Food- and Health-Related Correlates of Self-Reported Body Mass Index Among Low-Income Mothers of Young Children

OBJECTIVE To examine how income-related challenges regarding food and health are associated with variation in self-reported maternal body weight among low-income mothers. DESIGN Cross-sectional design. SETTING Two Northeastern cities. Seven day care centers and a Supplemental Nutrition Assistance Program outreach project. PARTICIPANTS Sample of 166 mothers; 67% were overweight or obese, 55% were Hispanic, and 42% reported household food insecurity (HFI). MAIN OUTCOME MEASURES Maternal self-reported height and weight to calculate body mass index (BMI). Independent variables were food program participation, supermarket use, 8-item food shopping practices scale, HFI, maternal depressive symptoms, and self-rated health. ANALYSIS Hierarchical multiple regression analysis tested relationships between maternal BMI with the independent variables of interest, adjusting for demographic confounds. RESULTS Shopping practices to stretch food dollars (P = .04), using community food assistance programs (P < .05), and HFI (P < .04) correlated with heavier maternal BMIs; higher self-rated health corresponded to lower BMIs (P = .004). CONCLUSIONS AND IMPLICATIONS Some strategies low-income mothers use to manage food resources are associated with heavier BMIs. Nutrition educators, public health practitioners, and researchers need to collaboratively address the associations between these strategies, food insecurity, poor health, and unhealthy weight.

Maternal Strategies to Access Food Differ by Food Security Status

BACKGROUND Household food insecurity is associated with health and behavior risk. Much less is known about how food insecurity is related to strategies that adults use in accessing food: how and where they shop, use of alternative food sources, and their ability to manage resources. OBJECTIVE To examine how maternal behaviors, including shopping, accessing alternative sources of food, and managing resources, are related to household food security status (HHFSS). DESIGN Cross-sectional study collecting survey data on HHFSS, shopping behaviors, use of alternative food sources, and managing resources obtained from low-income mothers of preschool-aged children. PARTICIPANTS One hundred sixty-four low-income mothers of young children (55% Hispanic) from two communities in Rhode Island. MEASURES HHFSS was measured using 10 items from the 18-item Core Food Security Module to assess adult food security. Mothers were surveyed about where, when, and how often they shopped; the strategies they use when shopping; their use of alternative sources of food, including federal, state, and local assistance; and their ability to manage their resources. STATISTICAL ANALYSIS Analysis of variance and χ2 analyses assessed the associations between demographic variables, shopping, accessing alternative food sources, and managing resources, and HHFSS. Multivariate logistic regression assessed the associations between HHFSS and maternal demographic variables, food shopping, strategies, alternative sources of food, and ability to manage resources. RESULTS Maternal age and language spoken at home were significantly associated with HHFSS; food insecurity was 10% more likely among older mothers (adjusted odds ratio [aOR] 1.10, 95% CI 1.03 to 1.17) and 2.5 times more likely among Spanish-speaking households (compared with non-Spanish speaking [aOR 3.57, 95% CI 1.25 to 10.18]). Food insecurity was more likely among mothers reporting more informal strategies (aOR 1.98, 95% CI 1.28 to 3.01; P<0.05) and perceiving greater inability to manage resources (aOR 1.60, 95% CI 1.30 to 1.98; P<0.05). CONCLUSIONS The results suggest that low-income mothers use a variety of strategies to feed their families and that the strategies they use vary by HHFSS. Community nutrition programs and providers will need to consider these strategies when counseling families at risk for food insecurity and provide guidance to minimize the influence on healthy food choices.

Commentary: Spare-Time Life of Chinese Children

Cet article propose un commentaire du rapport presente par Guan Ying dans le present numero, et consacre aux loisirs des enfants chinois